Information for Providers
Scheduled outages affecting all Frank members.
There will be a planned outage affecting all Frank members from 25 June until 1 July 2021. For more information, check out our fact sheet with all the details about how the outage will impact our systems and claims processes over this period.
Frank has been offering simple health insurance since 2009. We’re part of GMHBA, a well-respected not-for-profit health insurer with over 80 years of experience (they’ve been around since 1934).
Frank is here to make health insurance less confusing, cheaper and most importantly, something members will actually use. Simple and affordable health insurance and nothing else.
Here's what the Frank member card looks like:
Contacting Frank
If you have any questions, contact Frank on 1300 43 72 65.
Frank Health Insurance's ECLIPSE details
- Fund Brand ID: GMH
- Location ID: HSL00396
Information for hospital providers
Private Hospital Agreements
Frank members love the fact Frank has agreements with more than 480 private hospitals around Australia. The Australian Health Services Alliance (AHSA) takes care of the paperwork.
Refer to the AHSA agreement for your hospital.
If you have any questions for about Frank products or benefits, contact Frank on 1300 43 72 65.
Patient Eligibility Checks
You can perform Online Eligibility Checks (OEC) on ECLIPSE if a Frank member is being admitted to your hospital. All you need is the patient’s member number and admission details for an immediate response.
Refer to the Medicare ECLIPSE website for details on the functionality offered by each health fund.
ECLIPSE Hospital Claims
In short, billing Frank is just like sending an account to GMHBA.
You can submit Inpatient Hospital Claims (IHC) through ECLIPSE if a Frank member has been admitted to your hospital. All you need is the patient's member number and admission details.
Refer to the Medicare ECLIPSE website for details on the functionality offered by each health fund.
Information for Medical providers
Medical gap cover
Currently, Frank agrees to pay 120% of the Medicare Benefit Schedule (MBS) fee on all service types, excluding pathology and radiology. Please note this is changing from 1 May 2021 and Frank will instead pay inpatient medical benefits in line with the Australian Health Service Alliance’s Access Gap Cover scheme.
Access Gap Cover
From 1 May 2021, Frank will pay inpatient medical benefits in line with the Australian Health Service Alliance’s Access Gap Cover scheme.
Medical providers can find out more information about Access Gap Cover and register here.
ECLIPSE Medical Claiming
You can submit Inpatient Medical Claims (IMC) through ECLIPSE if you've treated a Frank member as a private patient in hospital. All you need is the patient's member number and treatment details.
Refer to the Medicare ECLIPSE website for details on the functionality offered by each health fund.
Claims outside of Access Gap Cover
Download a copy of the Frank Medical Gap Claim Account form and forward a copy of the completed form to [email protected].
Information for extras providers
If you're looking for details of Frank's Preferred, Member First, or Agreement network, you're not going to find them. Frank pays the same benefit, no matter who you are. So long as you're a registered provider of course.
Frank's members can swipe their member card to claim on the spot at any HICAPS or CSC HealthPoint terminal.
Frank participates in HICAPS Payments + Reconciliation solution and the Claims Settlement Service (CSS) for HealthPoint claims. That means payments for Frank members will be included the single settlement payment each day.
